16D2130650 CLIA NUMBER - WALMART PHARMACY 10-1241

Laboratory Demographics

  • CLIA Code: 16D2130650
  • Facility Name: WALMART PHARMACY 10-1241
  • Facility Address: 5811 ELMORE AVE
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: 563 359-4874
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLEN J. CONRAD
  • NPI Number: 1013934496
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2130650
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1241
Street 5811 ELMORE AVE
City DAVENPORT
State IA
ZIP 52807
Phone 563 359-4874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Pharmacy
Lab Director ALLEN J. CONRAD

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This page was last updated on: 9/29/2025